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儿科急诊胸痛患儿的特点。

Characteristics of chest pain among children presenting to the pediatric emergency department.

机构信息

Department of Pediatrics, College of Medicine, King Faisal University, AlAhsa, Saudi Arabia.

Department of Pediatrics, Maternity and Children Hospital, Eastern Health Cluster, Dammam, Saudi Arabia.

出版信息

J Med Life. 2023 Nov;16(11):1606-1610. doi: 10.25122/jml-2023-0280.

Abstract

Chest pain in pediatric patients is a common concern in pediatric emergency departments (ED). In most cases, benign conditions are related to noncardiac causes, and only a minority of the cases are caused by heart disease. This research aimed to evaluate the causes and characteristics of chest pain among children in a pediatric emergency department. This retrospective study evaluated children younger than 14 years of age who presented to the emergency department of a general pediatric hospital in the Eastern area of Saudi Arabia with non-traumatic chest pain between 2017 and 2022. The data included socioeconomic information, physical examination findings, and the results of basic investigations, such as chest X-ray and electrocardiogram. The Chi-square test was performed to compare various etiologies, with a 5% significant level. The study evaluated 310 patients with a mean age of 9.1±2.7 years. The majority of children presenting with chest pain had normal physical examinations, except 3.3% who showed respiratory and cardiac findings. The diagnostic tests indicated pneumonia in 2.9% and arrhythmia in 2.1% of children. Most patients were discharged with a diagnosis of idiopathic or muscular chest pain. The majority of patients (95%) were treated symptomatically in outpatient settings, with just one patient requiring hospitalization. The most common cause of chest pain prompting a child to visit the ED was idiopathic chest pain. Therefore, this study highlights the significance of obtaining a comprehensive medical history and physical examination to reveal important clues and help avoid unnecessary tests.

摘要

儿科患者的胸痛是儿科急诊部门(ED)常见的关注点。在大多数情况下,良性情况与非心脏原因有关,只有少数病例是由心脏病引起的。本研究旨在评估儿科急诊部门儿童胸痛的原因和特征。这项回顾性研究评估了 2017 年至 2022 年期间在沙特阿拉伯东部地区一家综合儿科医院急诊科就诊的年龄在 14 岁以下、有非创伤性胸痛的儿童。数据包括社会经济信息、体格检查结果以及基本检查(如胸部 X 光和心电图)的结果。采用卡方检验比较各种病因,显著性水平为 5%。该研究评估了 310 名平均年龄为 9.1±2.7 岁的患者。大多数出现胸痛的儿童体格检查正常,但有 3.3%的儿童有呼吸和心脏发现异常。诊断性检查显示 2.9%的儿童患有肺炎,2.1%的儿童患有心律失常。大多数患者被诊断为特发性或肌肉性胸痛而出院。大多数患者(95%)在门诊接受症状治疗,只有 1 名患者需要住院治疗。导致儿童就诊 ED 的胸痛最常见的原因是特发性胸痛。因此,本研究强调了获取全面的病史和体格检查以揭示重要线索并有助于避免不必要的检查的重要性。

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本文引用的文献

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Aetiological evaluation of chest pain in childhood and adolescence.儿童和青少年胸痛的病因学评估。
Cardiol Young. 2020 May;30(5):617-623. doi: 10.1017/S1047951120000621. Epub 2020 May 5.
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Follow-up study of patients admitted to the pediatric emergency department for chest pain.儿科急诊胸痛患者的随访研究。
Eur J Pediatr. 2020 Feb;179(2):303-308. doi: 10.1007/s00431-019-03495-5. Epub 2019 Nov 15.
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